Provider Demographics
NPI:1942703921
Name:MRT TRANSPORTATION LLC
Entity Type:Organization
Organization Name:MRT TRANSPORTATION LLC
Other - Org Name:AMERICAN LIBERTY TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KIDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-994-0163
Mailing Address - Street 1:PO BOX 5927
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85211-5927
Mailing Address - Country:US
Mailing Address - Phone:480-994-0163
Mailing Address - Fax:888-383-6359
Practice Address - Street 1:320 S NINA DR STE 17
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-8466
Practice Address - Country:US
Practice Address - Phone:480-994-0163
Practice Address - Fax:888-383-6359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty